Eosinophilic esophagitis (EoE) has been associated with an increased risk of esophageal mucosal tears induced by vomiting to dislodge impacted food or following endoscopic procedures. However, Boerhaave's syndrome or transmural perforation of the organ resulting from vomiting induced to dislodge impacted food has rarely been reported. In this article, we present two male adult patients with long-term esophageal symptoms who suffered from Boerhaave's syndrome after the impaction of food in the esophagus. Both patients required surgical management because of clinical and radiological signs of perforation. This rare complication of EoE has been documented in 11 other reports, predominantly affecting young men in whom EoE had not been previously diagnosed, despite the majority having esophageal symptoms and a history of atopy. There are only two published cases of esophageal perforation that presented in children, which were managed conservatively. Our two patients and 4 out of the 11 described in literature required surgery because of esophageal perforation. Our two cases involved closure of the perforation, while in three published reports, perforation resulted in a partial or complete esophagectomy. No cases have been published on Boerhaave's syndrome caused by EoE that ended in fatalities. It is important to note that esophageal perforation caused by vomiting is a potentially severe complication of EoE that is being increasingly described in literature. Therefore, patients with non-traumatic Boerhaave's syndrome should be assessed for EoE, especially if they are young men who have a prior history of dysphagia and allergic manifestations.

Percutaneous endoscopic gastrostomy (PEG) feeding represents the most effective and safest option for feeding patients with an impaired or diminished swallowing ability, despite having a functioning digestive system. The use of PEG has evolved to be useful in many situations beyond degenerative neuromuscular disorders, with an increasing body of evidence supporting the advantages of PEG tubes in oncologic and pediatric patients. Risk factors for complications after PEG tube placement include acute and chronic conditions associated with malnutrition and several organic disorders. Patients suitable for PEG tube placement should be individually identified to implement the advantages of this technique while minimizing risk events. The safety of placing a PEG tube in patients under antithrombotic medication has been investigated, as well as the advantages of antibiotic prophylaxis in reducing peristomal infection. Evidence supports the safety of early feeding after placement, thus resulting in lower costs. Percutaneous endoscopic gastrostomy-related complications are rare and mostly prevented by appropriate nursing care. Best medical practice and nursing care will ensure optimal performance leading to a wider acceptance, and greater utility of PEG by healthcare professionals, patients, and caregivers. This review aims to update knowledge relating to PEG tube indications, placement, management, and care in order to reinforce PEG feeding as the most valuable access for patients with a functional gastrointestinal system who have abnormalities in swallowing mechanisms.

Colonoscopy under endoscopist-controlled propofol sedation in low-risk patients is safe and effective, allowing for a complete exploration, although patients at least 65 years old and/or classified as ASA II are more likely to present a decrease in blood pressure and have a prolonged recovery time.

Most patients with adenomatous polyps in the right colon showed no synchronic adenomas on the left side. Lesions on the right side would have gone undetected if the individuals undergoing CRC screening had been explored with proctosigmoidoscopy.

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